Bill Clinton’s recent bypass surgery has captured a lot of attention. Some commentators publicly rebuked the former president for his fondness for fast food and cigars and for stopping his cholesterol-lowering medication.
There is no question that bad diet, smoking, lack of exercise and stress play major roles in the development of heart disease. So does high cholesterol.
Modifying these factors by increasing exercise, quitting smoking or lowering stress, for example, can dramatically reduce the risk of a heart attack.
Lowering bad LDL cholesterol with medication is also crucial. But not everyone can tolerate statin drugs such as Lipitor, Zocor, Crestor or Pravachol.
One reader reported: “I took Lipitor for years with no apparent ill effect.
Then suddenly I began to ache all over. A severe pain in my thumb spread within hours to the first two fingers as well and my hand began to swell up. My physician took me off Lipitor and put me on antibiotics.
“Next the pain and swelling moved to my feet and I could barely hobble. The rheumatologist I saw asked lots of questions and tested me, but offered no diagnosis. At one of the country’s leading hospitals, they decided I had a form of arthritis, prescribed ibuprofen for the pain and sent me home.
“At home I resumed my usual medicines, including Lipitor. And within three days I could barely walk again. I couldn’t drive my car because of the hand pain. A different doctor immediately diagnosed rhabdomyolysis and took me off the Lipitor.
“The warning in the commercials doesn’t begin to describe the bad effects of this drug. I am still handicapped despite physical therapy to strengthen my arm and legs.”
This woman was fortunate. Although considered very rare, drug-induced rhabdomyolysis can be deadly. Muscle breakdown can lead to kidney failure.
Most people taking cholesterol-lowering medications don’t experience a level of muscle breakdown that shows up on lab tests. But many patients do report less serious muscle pain or weakness. For some it shows up in the groin. Others report trouble with a shoulder, a thigh or a bad back. Because it can come on slowly, people may not make a connection to their medicine.
This reader wrote about her experience: “I took Pravachol. After about 10 to 14 days, I realized I was becoming very tired with achy muscles. I called my doctor who said there was a virus going around. She thought it wasn’t likely to be due to the Pravachol but she agreed I could stay off it for 2 or 3 weeks.
“Once I felt better, I started taking Pravachol again. After about 3 weeks I realized I had the same symptoms again. I had no energy and achy muscles. My arms were so tired that when hanging clothes in my closet, I couldn’t keep my arms raised for longer than a few seconds.”
“Again, she doubted it was a side effect of Pravachol, but she changed my prescription to Zocor. We will see what happens. So far so good.”
Some people are able to use a different kind of statin without the same side effect. Others have to switch to another strategy to lower cholesterol.
Stopping medicine without medical supervision is unwise. But no one should have to put up with crippling pain in order to control cholesterol.

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